Individual provider · Type 1 NPI

Justin Boutwell, PA

Medical Physician Assistant · Broken Bow, NE

NPI number 1861959017 Active

Practice location

145 Memorial Dr
Broken Bow, NE 68822-1378

Call (308) 872-2486 Map

Fax (308) 872-2027

Other practice locations

  • 1316 Logan St, Holdrege, NE 68949-1448 · (308) 991-4571

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X2387 (NE)

Medical Physician Assistant: Definition to come...

14 other providers at this address

About NPI 1861959017

Justin Boutwell, PA's National Provider Identifier is 1861959017, issued on Feb 25, 2019. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Broken Bow, NE. The record was last updated on Aug 19, 2019.